Alexander Kraig Anagnostou, CBT

Individual provider Active NPI Other Technician · Lacey, WA

NPI 1215430749 · NPPES record last updated Nov 14, 2018

Key facts

NPI
1215430749
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
8282 28TH CT NE Ste a
Lacey, WA 98516-7162
Phone
(360) 915-6868
NPI assigned
Mar 11, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Basics Northwest Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Yes

Addresses

Primary practice location

8282 28TH CT NE Ste a
Lacey, WA 98516-7162

Mailing address

525 Hillcrest Dr
Longview, WA 98632-5746
Phone (360) 270-1257

Other providers in Lacey, WA

All providers in Lacey, WA · Other Technician in Washington

Sources for this page

Verify at the official NPI Registry.